Iodine Deficiency in Patients with Hypothyroidism: A Pilot Study

OBJECTIVE: Worldwide, 21 countries have insufficient iodine in their diets. Persistent iodine deficiency may result in hypothyroidism. The aim of this study is to determine whether iodine measurements can be used to determine the prevalence of iodine deficiency in patients with (subclinical) hypothyroidism compared to a control group. DESIGN: A prospective cohort pilot study was performed at the Internal Medicine Outpatient Clinic of Isala, a large teaching hospital in Zwolle, the Netherlands. Patients. This study consisted of two groups of 24 adult patients each: a group of consecutive patients presenting with overt or subclinical hypothyroidism and a control group of euthyroid patients with type 1 diabetes mellitus. Measurements. All patients collected 24-hour urine. Iodine status was determined using urinary iodine concentration (UIC), urinary iodine excretion (UIE), and iodine creatinine ratio (I : Cr). Iodine deficiency was defined as an iodine concentration <100 µg/L for UIC, iodine level <125 µg for UIE, and <0.13 µmol/mmol for I : Cr. RESULTS: According to UIE and UIC measurements, 54.2% of hypothyroid patients were iodine-deficient compared to 41.7–45.8% in the control group. According to the I : Cr measurement 91.7% of hypothyroid patients were iodine-deficient compared to 87.5% in the control group. No significant difference was seen between the two groups. No correlation was found between thyroid-stimulating hormone (TSH) level and iodine deficiency. CONCLUSIONS: Iodine deficiency is prevalent in both hypothyroid patients and euthyroid patients. Because there is no significant difference between the groups, a single 24-hour urine or spot urine sample to determine UIC, UIE, and I : Cr, seems not suitable to determine iodine status in an individual participant.